2021 Living Rock Church Treasured VBS

Child #1

Child's name

Child's age

Child's gender

Male Female

Date of birth

Last grade completed

Child #2 (Optional)

Child's name

Child's age

Child's gender Male Female

Date of birth

Last grade completed

Child #3 (Optional)

Child's name

Child's age

Child's gender Male Female

Date of birth

Last grade completed

Child #4 (Optional)

Child's name

Child's age

Child's gender

Date of birth

Last grade completed

Child #5 (Optional)

Child's name

Child's age

Child's gender

Date of birth

Last grade completed

Contact Info

Name of parent(s)

Address

Primary contact number

This address will receive a confirmation email

Home church

Crew number or name (for church use only)

Allergies

Does your child have disabilities? (Optional)

Photo Permission:

YES. I give LRC permission to take pictures of my child(ren) for LRC promotional material. NO. I DO NOT give LRC permission to take pictures of my child(ren) for LRC promotional material.

In the event of inclement weather, we will post change of venue plans via text message. What numbers would you like us to text you at?

Phone #1

Phone #2 (Optional)

In case of emergency, contact:

Phone

Relationship to child

Payment

There are two registration options: single child for $15 or family for $30 (2 or more children qualify for the family rate). Each family must register SEPARATELY. If you have already paid, select the ALREADY PAID option at the very bottom.

And don't forget to select t-shirt sizes, which are included with the registration.

Registration:

T-Shirt Sizes:

Child #1

Child #2

Child #3

Child #4

Child #5

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Join us for a faith-filled adventure! Open to K - 6th grade and Preschool ages 3 and 4 (must be potty trained). $15 for individual; $30 for family.

Dates: August 2nd-6th
Time: 5:45-8:30 p.m.
Location: LRC church property (17125 County Road 31, Norwood Young America, MN 55368)

IMPORTANT: Each family must register separately. If finances are a concern contact:

Vonda Tiede, VBS Director, at vondavondavonda@rocketmail.com

And don't forget to click submit when you finish!

2021 Living Rock Church Treasured VBS

Description

Please Fix the Following